MR双反转恢复序列在脑内多灶性病变中的临床应用研究  

Clinical application of magnetic resonance double inversion recovery sequence in multifocal lesions of brain

作　　者：任宪会 赵斌[2] 

机构地区：[1]泰山医学院,山东泰安271016 [2]山东大学附属山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2016年第4期715-719,726,共6页Journal of Medical Imaging

摘　　要：目的探讨MR双反转恢复(DIR)序列在脑内多发缺血性病变、多发性硬化及脑转移瘤中的临床应用价值。方法回顾性分析经临床病理证实的肺癌脑转移20例、脑内多发缺血性病变20例、经随访证实的MS 20例的MR资料。所有患者均行了颅脑常规MRI及矢状位3D DIR扫描,肺癌脑转移患者平扫后继续行对比增强T_1WI(T_1WI+C)扫描。针对肺癌脑转移病人,以T_1WI+C上的病灶数目为参考,统计T_2FLAIR与DIR序列上的脑转移瘤数目;对于脑内多发缺血性病变及MS患者,计算病灶在DIR及FLAIR上的平均CNR、CR。所得数据应用SPSS 20.0软件进行统计学分析,判断两序列上病变数目、CNR及CR有无统计学差异。结果脑转移瘤在DIR图像上表现为低信号,周围常伴有片状长T_1长T_2信号,瘤体与周围水肿带分界清晰。T_1WI+C上的转移瘤数目为120个,T_2FLAIR序列上为61个,DIR上为94个,T_2FLAIR和DIR在病变数目上的差异有统计学意义(P<0.001)。脑内多发缺血性病变在DIR图像上可表现为明显高信号,同时表现为高信号的病灶在DIR及T_2FLAIR图像上的平均CNR分别为33.98±12.31、24.88±9.54,两者间的差异有统计学意义(P<0.05);平均CR分别为1.32±0.52、0.48±0.14,差异有统计学意义(P<0.001)。MS病灶在DIR上常表现为白质内的斑点、片状或不规则形高信号。病变在DIR及T_2FLAIR上的平均CNR分别为36.17±11.89、29.16±8.59,两者间差异有统计学意义(P<0.05);平均CR分别为2.37±0.86、0.66±0.19,差异有统计学意义(P<0.001)。结论 3D DIR成像技术较常规T_2FLAIR序列可以清晰的显示病灶,病灶的CNR及CR较高,同时在不使用对比剂的情况下可以发现更多的肺癌脑转移病灶。Objective To investigate the clinical application value of MR double inversion recovery（ DIR） sequence in multiple brain ischemic lesions,multiple sclerosis and brain metastasis. Methods The MR appearances of 20 cases with brain metastasis of lung cancer confirmed by clinical pathology,20 cases with multiple brain ischemic lesions and 20 cases with MS confirmed by follow-up were retrospectively analyzed. All patients were performed by the routine cerebral MRI and sagittal 3D DIR. And brain metastatic patients were performed by the contrast enhanced T_1 WI after the above scan. For brain metastatic patients,the number of brain metastasis on T_2 FLAIR and DIR,were evaluated based on the contrast enhanced T_1 WI. For multiple brain ischemic lesions and multiple sclerosis patients,the mean CNR and CR of lesions were calculated. The results were statistically analyzed using SPSS 20. 0 software. And the statistical difference of lesions number,CNR,and CR were estimated. Results Brain metastatic lesions were characterized by low signal accompanied by flake long T_1 long T_2signals on DIR images,tumors and surrounding edema had clear boundary. The numbers of brain metastasis on T_1 WI ＋ C,T_2 FLAIR and DIR sequences were 120,61 and 94,respectively,And the difference in the detection rate of brain metastasis between T_2 FLAIR and DIR was statistically significant（ P〈0. 001）. Multiple brain ischemic lesions can be characterized by obvious high signal on the DIR images. The mean CNR and CR of lesion,which showed the high signals on T_2 FLAIR and DIR at the same time,were 33. 98 ± 12. 31,24. 88 ±9. 54 and 1. 32 ± 0. 52,0. 48 ± 0. 14,respectively. And the differences between T_2 FLAIR and DIR were statistically significant（P〈0. 05; P〈0. 001）. MS lesions were often characterized by white spots,flake or irregular high signal on the DIR. The mean CNR and CR of lesions were 36. 17 ± 11. 89,29. 16 ± 8. 59 and 2. 37 ± 0. 86,0. 66 ± 0. 19,respectively. And the differences were statistically significant（

关 键 词：磁共振成像 双反转恢复序列 多发性硬化 脑转移瘤 缺血性病变 

分 类 号：R739.4[医药卫生—肿瘤] R445.1[医药卫生—临床医学]